Toxicology

Question 1

N/V, pallor, lethargy, progressing to RUQ pain, liver enlargement and tenderness, abnormal LFTs

Answer 1

acetaminophen toxicity

Question 2

tinnitus, N/V, tachypnea, hyperpnea. What is the most likely diagnosis?

Answer 2

salicylate toxicity

Question 3

Headache, fatigue, N/V, altered mental status, seizures possible, shock. What is the most likely diagnosis?

Answer 3

carbon monoxide toxicity

Question 4

headache, fatigue, N/V, altered mental status, seizures possible, shock. How do you diagnose?

Answer 4

PaO2 (normal) and pH (high anion gap metabolic acidosis)

Question 5

mitosis, lethargy, respiratory depression. Orthostatic hypotension, N/V. Histamine release resulting in localized urticaria. ileum and urinary retention possible. What is the most likely diagnosis?

Answer 5

opioid toxicity

Question 6

Neuromuscular excitability, autonomic dysfunction, altered mental status

Answer 6

TCA toxicity

Question 7

CNS depression, N/V, abdominal pain, acute pancreatitis. What is the most likely diagnosis?

Answer 7

isopropyl alcohol toxicity

Question 8

CNS depression, metabolic acidosis, visual changes. What is the most likely diagnosis?

Answer 8

methanol toxicity

Question 9

CNS depression, metabolic acidosis, renal failure. What is the most likely diagnosis?

Answer 9

ethylene glycol toxicity

Question 10

What is the treatment for acetaminophen toxicity?

Answer 10

N-acetylcysteine, activated charcoal

Question 11

What is the treatment for salicylate toxicity?

Answer 11

Sodium bicarbonate, benzos if seizing, activated charcoal

Question 12

What is the treatment for CO toxicity?

Answer 12

100% high flow O2

Question 13

What is the treatment for opioid toxicity?

Answer 13

Naloxone

Question 14

What is the treatment for TCA toxicity?

Answer 14

Sodium bicarbonate, benzos is seizing, activated charcoal

Question 15

What is the treatment for methanol or ethylene glycol toxicity?

Answer 15

Fomepizole

Question 16

What is the treatment for beta blocker toxicity?

Answer 16

Glucagon

Question 17

What is the mnemonic for anion gap metabolic acidosis?

Answer 17

M - Methanol
U - Uremia
D - DKA
P - Paraldehyde
I - Iron, isoniazid
L - Lactic acidosis
E - Ethanol, ethylene glycol
S - Salicylate

C - Carbon monoxide
A - ahminoglycosides
T - Theophylline

Question 18

Chest pain, SOB, neurological symptoms, HTN, tachycardia, mydriasis, hyperthermia. Most likely diagnosis?

Answer 18

Cocaine toxicity

Question 19

Chest pain, SOB, neurological symptoms, HTN, tachycardia, mydriasis, hyperthermia. Treatment?

Answer 19

Benzodiazepines

Question 20

atrial tachycardia with AV block.

Answer 20

digoxin toxicity

Question 21

How do you remember the symptoms of anti-cholinergic syndrome?

Answer 21

Hot as a hare
Blind as a bat
dry as a bone
red as a beet
mad as a hatter

Question 22

How do you remember the symptoms of cholinergic syndrome?

Answer 22

D - diarrhea
U - urination
M - Myosis/muscle weakness
B - bronchorrhea
B - bradycardia
E - emesis
L - lacrimation
S - salivation/sweating

Question 23

How do you treat anticholinergic syndrome?

Answer 23

IV fluids and Benzos as needed. Physostigmine if severe symptoms

Question 24

How do you treat cholinergic syndrome?

Answer 24

atropine and pralidoxime

Question 25

altered mental status, seizure, skin flushing, and tachypnea after receiving nitroprusside. Most likely diagnosis?

Answer 25

Cyanide toxicity

Question 26

How do you treat sulfonylurea overdose?

Answer 26

Octreotide and D50 as needed for hypoglycemia